The Cumulative Impact of Child Maltreatment and Teen Pregnancy on Depression in Young Mothers

Background. Teen pregnancy is associated with a range of adverse outcomes, including depression. The scientific literature has sought to elucidate the potential explanatory pathways leading to depression, yet questions remain. It is often difficult to disentangle the potential confounding factors (e.g., poverty, education, trauma) that may also influence the mental health of teen parents. That is, do the stressors of teen pregnancy contribute to depression or do early life stressors (e.g., child maltreatment) that often result in depression also predict teen pregnancy?

Methods. This study examined the effects of child maltreatment and teen pregnancy on depression in late adolescence using an eight-year longitudinal design. Female participants (N = 207)—all from low-income households—were initially assessed at ages 10-12-years-old and then subsequently followed up eight years later, at 18-21-years-old. Child maltreatment was assessed with a systematic coding (Barnett, Manly, & Cicchetti, 1993) of Department of Human Services records. Depression was measured with the Diagnostic Interview Schedule for DSM-IV (DIS-IV; Robins et al., 1995), Beck Depression Inventory (BDI-II; Beck et al., 1988) and Adult Behavior Checklist—Internalizing (Achenbach, 1997) in late adolescence/early adulthood. Teen pregnancy was determined if an individual reported a pregnancy in the range of 13-19-years-of-age.

Results. Two-way ANOVA, were conducted to examine the effect of teen pregnancy and child maltreatment on depressive symptom scores on the BDI-II, DIS-IV and ABCL. There was a statistically significant interaction between the effects of teen pregnancy and child maltreatment on mean BDI score, F (1, 207) = 6.19, p = .014 and ABCL-Internalizing score, F (1, 207) = 6.70, p = .010. Simple main effects analysis showed that pregnant teens with a history of child maltreatment had significantly higher rates of depressive symptoms than the other three groups: pregnant teens without maltreatment, non-pregnant teens with maltreatment, and non-pregnant teens without maltreatment.

Implications. The results suggest that teen mothers with a history of child maltreatment are more likely to develop depression than individuals with child maltreatment or teen pregnancy alone.  The experience of teen pregnancy may evoke negative mental representations of caregiving figures (Fraiberg, 1975) associated with the teen’s experience of child maltreatment, contributing to the development of depression. This knowledge is informative for social workers seeking to ameliorate the adverse effects of maternal depression on the parent and child. Pregnant teenagers should be screened for maltreatment histories and should be targets for early intervention services, including relational interventions, from the perinatal period throughout early childhood.